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With the joy of summer and easing of some COVID-19 restrictions, children and families are eager to be outdoors and active. Sadly, accidents, many of which are preventable, are a leading cause of morbidity and mortality in children and teenagers.
As the weather gets warmer and we are increasingly liberated from COVID-19 constraints, accident prevention should become a high priority. As pediatricians, we appropriately focus on physical measures like helmets for biking or skateboarding, seat belts when in cars, and self-locking fences and gates around pools. Less often do we consider psychosocial issues that could significantly affect the risk for injury from accidents.
For younger children, drowning (about 1000 deaths per year) and unintentional gunshots (about 3000 firearm-related injuries) are the most common accidents.1 Both types of events happen quickly. Pools should have proper fences and gates. Guns should have trigger locks with ammunition stored and locked in a separate site. In addition, pediatricians should ask about potential stressors that could distract parents. Are the parents supervising several young children at the same time? Is there an elderly or ill parent who needs constant attention in the home? Is there family conflict that has resulted in distractions? Is there substance abuse, especially alcohol, that has interfered with childcare? These questions can seem hard to ask, but if, for example, the pediatrician starts by inquiring about access to a pool and then notes the dangers of drowning, these questions will be seen as caring and not critical.
Given an adolescent’s less-developed sense of judgment and often heightened self-confidence, teenagers don’t often stop to ask, “should I take this risk?” Children and adolescents with short attention spans, impulsivity, and depression are at increased risk, because these conditions further impair judgment and result in less consideration about safety. Pediatricians can assess a teenager’s behavior and judgment, and then have a frank conversation about potential decisions that youth may have to make. What kind of dangerous behaviors have they seen among peers? How do they decide how much to drink at a party? How rigorous are they about drinking and being a passenger or driving themselves? Will their friends watch out for them? Do they have good judgment? If they tend toward depression, do they ever think about taking a risk and not really caring about the consequences? Of course, parents have the major role in accident prevention. Pediatricians can ask how parents see their children reacting to safety measures. Do they accept seat belts and helmets, and how do their children assess risks? Have parents reviewed various scenarios for when their children and teenagers are on their own, such as with friends in a park, at a pool, at a party? Have there been forthright conversations about being vulnerable when drunk and how parents will react to a call for help if that call avoids a dangerous situation? What kind of risks did the parents take as teenagers? What behaviors do they demonstrate with alcohol or when driving? What parents do as role models far outweighs what they say.
Summer is a good time to prioritize accident prevention. Send out some information electronically prior to a visit, have some materials in the waiting room, and pick a question or 2 to ask during visits with your patients as the weather gets warmer.
1. Brady United. Key statistics. Accessed May 1, 2021. https:www.bradyunited.org/